Excess weight in adolescents is associated with increased risk of hyperlipidemia and type 2 diabetes, and its prevalence is increasing worldwide, according to background information in the article. In the United States, the proportion of adolescents with a body mass index (BMI) at or above the 95th percentile for age, a widely accepted definition of obesity in adolescents, has increased 15.5 percent to 23.4 percent in certain ethnic minorities. Overweight children are at a 15-fold greater risk of becoming overweight adults compared to children and adolescents not overweight. Pediatric obesity can be particularly difficult to treat, with long-term success depending on the type of therapy used. Orlistat is a gastrointestinal tract lipase (an enzyme) inhibitor which decreases intestinal fat absorption by up to 30 percent; in adults, the drug has a good safety profile and is generally well tolerated.
Jean-Pierre Chanoine, M.D., Ph.D., from the British Columbia Children's Hospital, Vancouver, and colleagues examined the effectiveness and safety of orlistat for weight management in adolescents, in this 54-week, randomized, double-blind study. Participants were aged 12 to 16 years and had a BMI (calculated as weight in kilograms divided by the square of height in meters) two units or more above the 95th percentile at baseline. Three hundred fifty-seven patients received 120 mg of orlistat three times daily and 182 participants received placebo three times daily for one year. Both groups were given instructions on how to maintain a reduced calorie diet, and received counseling for exercise and behavior modification (i.e., recording food intake, recognizing cues for overeating). The researchers also assessed t
Contact: Jean Pierre Chanoine, M.D., Ph.D.
JAMA and Archives Journals